Provider Demographics
NPI:1194494401
Name:DOUGAN, LYNDSEY (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:
Last Name:DOUGAN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08343-1864
Mailing Address - Country:US
Mailing Address - Phone:856-906-2565
Mailing Address - Fax:
Practice Address - Street 1:144 BRENNEN DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-3906
Practice Address - Country:US
Practice Address - Phone:302-292-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0012304225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty